The efficacy of biomarkers indexes in comparison with Echocardiography in assessment of antracycline induced cardiotoxicity in cancer patients

Background: Anthracyclines are the most frequent cause of treatment-induced cardiotoxicity and can cause severe morbidity and mortality during the life. Objective: The aim of the present study was to assess the validity and efficacy of cardiac biomarkers such as serum troponin I and creatine phosphokinase MB versus the standard echocardiography for early diagnosis of anthracycline-induced cardiotoxicity. Methods: This was an analytical study in which 46 cancer patients who received anthracyclines-containing chemotherapy were investigated during 2007 to 2008.patients were selected based on obtaining a convenience sample using a consecutive sampling method. The serum levels of CKMB and cTnI were measured before treatment, after the third cycle of therapy, and following the completion of chemotherapy. Echocardiography was performed a year later for monitoring the cardiac function. Data were analyzed using chi square, Fisher’s Exact and ANOVA tests. Findings: Our results showed that among three diagnostic methods (serum cTnI, CKMB measurements, and echocardiography) to diagnose anthracycline-induced cardiotoxicity, the echocardiography was found to be of higher value compared to other two laboratory tests measured (p<0.000). Conclusion: Considering the high diagnostic value of echocardiography in monitoring the cardiac function during anthracycline containing chemotherapy and also high cost of laboratory testing of CKMB, cTnI, it recommended that the ECG to remain as a valuable and cost-effective technique in monitoring the cardiac function.